Examining the Influence of the ToyotaExamining the Influence of the Toyota Production System Patient Safety Curriculum Production System Patient Safety CurriculumOn the Clinical Judgment Ability of Nursing StudentsOn the Clinical Judgment Ability of Nursing Students

Jennifer Olszewski, MSN, CRNPJennifer Olszewski, MSN, CRNPDrexel University, Ed.D ProgramDrexel University, Ed.D Program

AbstractAbstract

Ensuring patient safety and positive patient outcomes is a priority in healthcare, which requires leadership on multiple levels. Nurses have been identified as key stakeholders to safeguard patient outcomes, therefore it is necessary for nurses to practice with clinical judgment incorporating leadership skills at the bedside. Nursing educators are now challenged to create innovative curricular changes to enhance clinical judgment and develop leadership skills n nursing students in an effort to prepare future nurses to act as leaders.

IntroductionIntroduction ReferencesReferences

Healthcare in American is in a crisis, which requires collaborative change to ensure a high quality of care that is safe for all patients. The Institute of Medicine (IOM) uncovered that approximately 98,000 deaths occur annually as a result of medical error (2000). Research identifies that a lack of clinical judgment regarding key leadership qualities impedes patient safety (IOM, 2000). In response to this need, Drexel University’s Undergraduate Nursing program has adapted a patient safety model based on the Toyota Production System (TPS). This TPS model has been adapted for the healthcare setting and utilized by several hospital institutions. Drexel University is the first educational institution to incorporate a standard patient safety model.The Challenge“Produce leaders throughout the healthcare system, from the bedside to the boardroom, who can serve as full partners with other health professionals and be accountable for their own contributions to delivering high quality care while promoting patient safety” (IOM, 2010).

Baumberger, M.H. (2005). Cooperative learning and case study: Does the combination improve nursing students’ clinical judgment? Nurse Education Today, 25, 238-246.Chenot, T.M., & Daniel, L.G. (2010). Frameworks for patient safety in the nursing curriculum. Journal of Nursing Education, 49 (10), 55-568Institute of Medicine (2010). The Future of Nursing: Leading Change, Advancing Health. Unpurblished. Retrieved from: Http;//www.nap.eduLasater, K., & Nielsen,A. (2009). The influence of concept-based learning activities on students’ clinical judgment development. Journal of Nursing Education, 48 (8), 441-446.Richardson, A., & Storr, J. (2010). Patient safety: A literature review on the impact of nursing empowerment, leadership and collaboration. International Nursing Review, 12-21.

PurposePurpose Research QuestionsResearch Questions

Review of the LiteratureReview of the Literature

The Problem The Problem

MethodologyMethodology

• Control group ratings and thematic analysis• Experimental group TPS case studies in the Spring

and Summer quarters• Experimental group Failure to Rescue simulation and

focus group interviews

Next StepsNext Steps

AcknowledgementsAcknowledgements

Joyce Pittman, PhD, Dissertation SupervisorElizabeth Haslan PhD, Dissertation Committee MemberFaye A. Meloy, PhD, Dissertation Committee Member

Contact information: jro27@drexel.edu

Educational InterventionEducational Intervention

Implementation of the TPS Model•Evolving patient case studies in clinical courses

• Developed by expert clinical faculty trained in the TPS model

• Simulations• Failure to Rescue simulation in

the final term of the program

Research Setting• Drexel University College of

Nursing and Health Professions

• Accelerated Career Entry (ACE) Students

To investigate if the implementation of the Toyota Production System (TPS) Patient Safety Curriculum will influence undergraduate nursing students’ clinical judgment ability to promote patient safety.

:Conceptual FrameworkConceptual Framework

.

1. Patient safety• Significant relationship between nursing leadership skills

and adverse patient outcomes (Richardson & Storr, 2010),

• Need for patient safety curriculum in nursing and medicine (Chenot & Daniel, 2010).

2. Nursing Leadership in Education• New nurses revealed a lack of competence and

experience in decision making and prioritizing during times of uncertainty and chaos (Wangensteen et al., 2008).

3. Developing Clinical Judgment• Use of case studies as a pedagogical approach

improved clinical judgment (Lasater & Nielson, 2009; Baumberger, 2005).

 

.

1. Is there a significant difference in the clinical judgment of nursing students that participated in the TPS patient safety curriculum with the cohort that did not participate in this curriculum?

2. How did simulation influence the integration of theory and practice in the development of clinical judgment skills?

3. How did the participants perceive their ability or preparedness to function in the simulation?

GA

P

Assumptions & LimitationsAssumptions & LimitationsAssumptions:•Student engagement•Student desire to promote safetyLimitations•Simulation•Previous exposure•Sample•Attrition